OIG Benefits Program Integrity recovers nearly $18 million in third quarter

The Benefits Program Integrity (BPI) division opened 2,587 investigations involving some form of benefit recipient overpayment or fraud. BPI investigates allegations of overpayments to health and human services program clients enrolled in the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF) program; Medicaid; Children’s Health Insurance Program (CHIP); and the Women, Infants, and Children (WIC) program.

During the third quarter, 80 percent of the new cases involved unreported income (30 percent) or an issue with the reported household composition (50 percent). Household composition cases usually involve an unreported household member who has income but could also include a household member who does not actually live in the same residence. Both instances cause the household to receive more benefits than it is entitled to. Other types of opened investigations (20 percent) include prison matches, felony drug convictions, felony fugitive matches or dual participation of benefits in other states.

BPI completed 311 investigations during the third quarter where fraud was found. BPI referred 36 investigations for prosecution and 275 for an administrative disqualification hearing. Ninety percent of fraud investigations completed involve either unreported income (17 percent) or an issue with the reported household composition (73 percent).

You can read more about the OIG’s work during the third quarter by reading the OIG Quarterly Report here.